(A006) Longitudinal Trends in Otolaryngology Residency Applications from 2018 to 2024

Introduction: The otolaryngology (OTO) residency application landscape has undergone significant transformations from 2018 to 2024, characterized by dynamic shifts in application strategies, academic performance, and candidate experiences.

Methods: A comprehensive retrospective analysis of the Texas STAR database examined longitudinal trends across multiple OTO application metrics, including number of applications submitted, interviews received, academic performance, research activities, and experiential factors.

Results: Application submissions increased steadily from 65.55±20.58 (2018, mean±SD), peaking at 80.38±34.98 (2023), before declining to 49.93±25.82 (2024, p< 0.001). Interview numbers decreased from 22.11±10.21 (2018) to 14.53±8.42 (2021), remaining stable between 2023 and 2024 (14.10±5.50 in 2024, p=NS). Peer-reviewed publications increased from 2.94±2.78 (2018) to 6.92±3.91 (2023), before declining to 4.49±3.63 (2024, p< 0.01). Volunteer and leadership positions demonstrated stability from 2018-2023, with a significant decline from 2023 to 2024 (p < 0.01). Step 2 scores remained consistent across the years, with a mean score of 256.97±9.41 in 2018 and a slight increase to 259.23±7.67 (2024, p=NS). Clerkship honors decreased from 4.52±2.28 in 2018 to its lowest at 3.75±2.62 (2023) then back to its peak of 4.81±2.12 (2024, p< 0.01).

Conclusions: OTO resident application submissions and publications peaked in 2023 before dropping in 2024 while volunteer and leadership were stable before their decline in 2024. Additionally, in 2024, clerkship honors demonstrated a statistically significant increase, along with a non-statistically significant increase in step 2 scores. Our results suggest the increasing importance of clinical education in distinguishing OTO residency applicants, most notably since step 1 went pass/fail.